A medical nurse is caring for a patient with type 1 diabetes. The patient's medication administration record includes the administration of regular insulin three times daily. Knowing that the patient's dinner tray will arrive at 1645, when should the nurse administer the patient's insulin to ensure the onset of the insulin coincides with the start of the meal?

1645

1615

1545

1600

Answer and Explanation

The Correct Answer is B

A. Regular insulin typically begins to take effect 30 minutes after administration. Administering insulin at the time of the meal (1645) would not allow enough time for the insulin to reach its onset of action, potentially resulting in the blood glucose level being high during the meal.

B. Regular insulin has an onset of action of 30 minutes. By administering the insulin at 1615, it will start to take effect by 1645, when the meal arrives, and help ensure the insulin action aligns with the meal, preventing postprandial hyperglycemia.

C. Administering insulin at 1545 would be too early and could lead to the insulin peaking before the meal, which could result in hypoglycemia if the insulin peak occurs before the patient has food to absorb the glucose.

D. Administering insulin at 1600 would result in the insulin starting to work too soon, with the onset happening before the meal and possibly leading to hypoglycemia if the insulin peaks before the meal is consumed.

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Correct Answer is D

Explanation

A. Respiratory Acidosis:
Explanation: Respiratory acidosis occurs when there is inadequate elimination of carbon dioxide, leading to an increase in PaCO2 and a decrease in blood pH. This is typically associated with conditions that impair ventilation.

B. Metabolic Alkalosis:
Explanation: Metabolic alkalosis is characterized by an elevated blood pH and bicarbonate (HCO3-) concentration. It is not directly caused by hyperventilation but is often associated with conditions such as excessive vomiting or excessive bicarbonate intake.

C. Metabolic Acidosis:
Explanation: Metabolic acidosis is characterized by a decrease in blood pH and bicarbonate concentration. It is not directly caused by hyperventilation but may result from conditions such as diabetic ketoacidosis or lactic acidosis.

D. Respiratory Alkalosis:
Explanation: Hyperventilation is the most common cause of respiratory alkalosis. During hyperventilation, there is an excessive loss of carbon dioxide (CO2) through rapid breathing, leading to a decrease in the partial pressure of carbon dioxide (PaCO2) in the blood. This results in an increase in blood pH, causing an alkalotic state.

A. 30 minute onset; 2 hour duration B. 15 minute onset; 30-60 minutes peak C. 2 hour onset; 12 hour duration D. 15 minute onset; no peak (continuous)

Correct Answer is B

Explanation

A. 30 minute onset; 2-hour duration: This does not accurately represent the onset and peak action time of Insulin Lispro.

B. 15 minute onset; 30-60 minutes peak: This is correct. Insulin Lispro has a rapid onset (starts working within 15 minutes) and a peak action time of 30-60 minutes after administration.

C. 2-hour onset; 12-hour duration: This is not accurate for rapid-acting insulin. Rapid-acting insulin has a much quicker onset and shorter duration compared to this option.

D. 15 minute onset; no peak (continuous): While the onset time is correct, stating "no peak" is not entirely accurate. Rapid-acting insulin does have a peak, but it's relatively short, occurring within the first hour after administration.

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Naxlex Comprehensive Predictor Exams

A patient with a longstanding diagnosis of generalized anxiety disorder presents to the emergency room. The triage nurse notes upon an assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the MOST common cause of which acid-base imbalance?

Correct Answer is D

Explanation

A client with diabetes mellitus is ordered to receive insulin for glucose correction (sliding scale coverage). The nurse knows the rapid acting insulin Insulin Lispro (Humalog) onset and peak action time are:

Correct Answer is B

Explanation

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